History Taking - Respiratory

Respiratory history taking is an important skill that is often assessed in the OSCE setting. Its important to have a systematic approach to ensure you dont miss any key information. The guide below provides a framework to take a thorough respiratory history.

History of Presenting Complaint

  • Onset - When did the symptom start
  • Acute or gradual - Did it come on suddenly or has it gotten worse gradually Duration - minutes / hours / days / weeks / months / years
  • Progression - Has it gotten worse/better or stayed same over the stated time frame
  • Intermittent or continuous - Is the symptom always there or does it come and go
  • SOB - only on exertion or at rest how far can the patient walk before needing to rest
  • Pain - if pain is a symptom, clarify the details of the pain using SOCRATES
  • Site - where exactly is the pain / where is the pain worst
  • Onset - when did it start / did it come on suddenly or gradually
  • Character - what does it feel like (sharp stabbing / dull ache / burning)
  • Radiation - does the pain move anywhere else (e.g. chest pain with left arm radiation)
  • Associations - any other symptoms associated with the pain (e.g. chest pain with SOB)
  • Time course - does the pain have a pattern (e.g. worse in the mornings)
  • Exacerbating / Relieving factors - anything make it particularly worse or better
  • Severity - on a scale of 0-10, with 0 being no pain & 10 being the worst pain youve ever felt

Associated symptoms:

  • Dyspnoea - only on exertion or at rest how far can the patient walk before needing to rest
  • Cough - productive sputum (volume, colour, consistency, blood)
  • Wheeze - any particular time of day any triggers (pets, cold air, work, pollen)
  • Haemoptysis malignancy, bronchiectasis, PE
  • Weight loss - chronic infection, malignancy
  • Chest pain - pleuritic pneumothorax / pneumonia / PE
  • Orthopnea heart failure, COPD
  • PND heart failure
  • Dizziness/ Tingling in finger & toes hypoxia